Provider Demographics
NPI:1407230444
Name:OLALOWO, RISIKAT MOJISOLA
Entity Type:Individual
Prefix:
First Name:RISIKAT
Middle Name:MOJISOLA
Last Name:OLALOWO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 OCEAN AVE
Mailing Address - Street 2:APT 1-C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-7473
Mailing Address - Country:US
Mailing Address - Phone:347-357-4019
Mailing Address - Fax:
Practice Address - Street 1:1212 OCEAN AVE
Practice Address - Street 2:APT 1-C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-7473
Practice Address - Country:US
Practice Address - Phone:347-357-4019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-18
Last Update Date:2015-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY700220163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse